APMA News - July 2011 - (Page 36)

Reimbursement Health Policy Committee Issues—Part II The following is the second installment in a two-part series outlining current health-policy issues for podiatrists. QUESTION: What is the Health Policy Committee (HPC) doing to address issues affecting podiatrists as a result of the enacted health-care reform and other changes in Medicare? ANSWER: As indicated in part one, this is a pivotal year for the HPC. Its members are dealing with a full slate of issues, including Tricare, routine foot care, the medical staff president issue, and orthotics. APMA representatives met with CMS staff on the issue. Though CMS had indicated at a prior meeting that the changes APMA suggested could be made simply, CMS staff recanted, indicating the necessary changes might require regulatory action. APMA continues to assist CMS on this issue, and HPC and APMA staff are considering all available options. Conditions of Participation Health Policy & Practice Department staff met with CMS representatives in March 2010 to discuss the provision that prevents DPMs from serving as presidents of their medical staffs. CMS recently included a major revision of the Hospital Conditions of Participation on its agenda as a result of the president’s executive order to conduct a retrospective analysis of existing regulations. This revision may address APMA’s concerns about the hospital medical staff president issue. Because this proposed rule is likely to be quite lengthy, however, it may take a long time for it to be unveiled. CMS stated it may be willing to pursue a change but would want to bundle APMA’s request with other proposed changes. HPC provided CMS with requested materials, including additional statistics and support for APMA’s position. When APMA contacted CMS in October 2010, the association was informed that CMS intends to “pursue efforts to update the hospital Conditions of Participation in a number of areas,” which APMA understands to include addressing its concerns. CMS estimated that this process could take 18–24 months from draft rule to implementation. Tricare Podiatrists are currently unable to order and prescribe durable medical equipment (DME) under the Tricare program— a policy administered inconsistently across the country. APMA representatives recently met with staffers for Senators from the Senate Armed Services Committee in an attempt to expedite resolution of this issue. Based on those staffers’ inquiries, Tricare has tentatively agreed to single out APMA’s issue from other DME issues under consideration, which should help move it toward resolution. Tricare informed APMA staff last year that it was drafting a proposed rule to address our concerns. While Tricare appeared willing to work with APMA in revising its regulations, it was unclear to APMA what progress was being made, the nature of the changes, and even when the issue would be addressed. APMA already has succeeded in having Tricare include DPMs as Class 1 providers for purposes of reimbursement, and the association continues to encourage inclusion of DPMs as “physicians” to eliminate other potentially discriminatory issues. L3000 Coalition/Working Group HPC has met with various foot orthotic device stakeholders (American Orthotic and Prosthetic Association, Prescription Foot Orthotic Laboratory Association, Pedorthic Footcare Association, etc.) to discuss the need to formulate a new series of codes or recommend or modify existing HCPCS codes for foot orthotics (including L3000). As a result, the stakeholders agreed to continue this dialogue and meet again as needed. The group has initiated its process by comparing terminology and definitions and is identifying common interests. A second meeting occurred in early May 2011. Routine Foot Care: CMS Medicare Benefit Policy and Claims Processing Manuals APMA is assisting carrier advisory committee representatives for Jurisdiction 4 Medicare Administrative Contractor states in the southwest (TrailBlazer) with their concerns regarding an overly restrictive routine foot care LCD. In a conference call with the TrailBlazer Medicare medical director, a number of issues were discussed and clarified, and participants laid out a course for possible resolution. APMA continues to communicate with CMS staff regarding Medicare coverage policies for foot-care services, because CMS has indicated it may revise the foot-care section of §290 of Chapter 15 of the Medicare Benefit Policy and the Medicare Claims Processing Manual. On July 6, 2010, APMA provided feedback to CMS on suggested changes and improvements to the Medicare Benefit Policy Manual §290. In December 2010, 36 APMA News July/August 2011 Next Steps HPC is prioritizing the issues listed above, as well as new issues that arise. The committee is dedicating resources in an effort to obtain favorable resolution for members and will keep members informed of its progress. For more information on health policy developments, visit http://members. apma.org/Members/ReimbursementIssues.aspx. n http://www.apma.org/yourpractice/content.cfm?ItemNumber=1367&navItemNumber=594 http://www.apma.org/yourpractice/content.cfm?ItemNumber=1367&navItemNumber=594

Table of Contents for the Digital Edition of APMA News - July 2011

APMA News - July 2011
President’s Message
Contents
PICA Reflects on its Past, Looks to the Future
APMA Media Event Wrap-Up: Toning Shoes Are All The Rage, Along with Podiatrists' Expert Advice
APMA Member Testifi es Before Congressional Committee on Health IT
Stepping Up to Prevent Falls: Part II
Resident Experts: CPME's Residency Evaluators Share Their Stories
Strategic Planning Retreat Underscores APMA Direction
Reimbursement
Can They Really Do That?
Members Who Know Media
Technofile
Young Voices
Federal Advocacy Forum
Small Business 101
CPME Update
APMAPAC Chair Report
APMA All Stars
In Short
Worthy of Note
Affiliates Corner
Insurance Advisor
New Members
Death Notices
APMAPAC Update
Development Update
Annual Scientific Meeting Sponsors
Committee Nominations
Bylaws Propositions Due
Classified Advertising
Dates to Remember
Advertising Index
Ten Questions

APMA News - July 2011